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Article written by:

David Shannon, Senior Physiotherapist

There has always been a lot of discussion in sports medicine circles about ways of reducing concussion and/or the severity of the effects of concussion.

Wearing mouth guards has been shown to reduce the incidence of dental and mandibular (jaw) injuries. Nowadays it is a commonly accepted practice that participants in contact sports should wear a laminated custom-moulded (therefore properly fitting) mouth guard. A recent article in the Age (2/6/12) described a plan to trial “smart” mouth guards – fitted with an accelerometer designed to hopefully improve our understanding of the forces involved in producing the effects of concussion and the potential link with long-term impact on players’ brains. Both he AFL and ARL have welcomed the opportunity to further our knowledge of this area of injury in sport.

However, to date there is no evidence that wearing mouth guards reduces the likelihood of concussion.

The other type of protective gear that is commonly used in contact sports is a helmet. Admittedly usage of helmets is more common on North America, especially in the National Hockey League and American Football. The whole issue of head injury in sport has been the subject of debate in North America with a number of professional ice hockey players absent from the game for lengthy periods due to the effects of repeated head injuries.

At much the same time there has been some research into post-career incidence of the effects of repeated head injuries – notably depression, cognitive changes, and long-term brain damage as seen with boxers who suffer repetitive head injuries over their careers.

At this stage in the debate it is widely accepted that helmets are effective in protecting against catastrophic head injury, eg. Fall from motorbike or bicycle, but have not been found to be effective in preventing the more common types of head injury such as concussion. In fact the use of helmets in contact sports such as ice hockey and grid-iron is widely believed to have a negative effect. This has been described as ‘risk compensation’ – the effect of competitors erroneously believing that wearing the helmet reduces the risk of head injuries thus leading to higher incidence of riskier practices such as head-high tackles or collisions.

The consensus amongst researchers and administrators alike is that making our contact sports as safe as possible, whilst retaining the obvious benefits that participation in team sports offers, should be a major focus. To this end, appropriate rules and rule enforcement are vital,. Improved strategies for assessment and management of concussion injuries filter down from elite levels such as the AFL – as to whether helmets might be part of these strategies – the evidence to date would suggest not.

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